One of the most important problems in today's intensive care units (ICUs) is high nursing workload. The overall objective of the proposed research is to examine the impact of high nursing workload on ICU nurses and patients. In order to achieve its overall objective, this research study proposes a conceptual model of nursing workload that includes four main elements: work obstacles and facilitators; workload; quality of working life (QWL); and perceived quality and safety of care. Work obstacles are inhibiting work factors in the immediate work setting, and work facilitators are facilitating work factors in the immediate work setting. The conceptual model is used as a guide to accomplish two specific aims derived from the overall objective. The first aim is to investigate the impact of work obstacles and facilitators on nursing workload in ICUs. A range of obstacles in the work system may contribute to high nursing workload in an ICU. Identifying these obstacles and facilitators is crucial in order to correctly focus efforts in an ICU redesign project that aims at reducing nursing workload by eliminating these obstacles and increasing facilitators. The second aim is to examine the impact of workload on QWL and perceived quality and safety of care among ICU nurses. The study will be conducted in two phases. The first phase includes the development and pilot testing of the work obstacles and facilitators questionnaire for ICU nurses. This questionnaire will be used in the second phase of the study. The second phase uses a cross-sectional design in order to assess the impact of work obstacles and facilitators on nursing workload, QWL and perceived quality and safety of care. The proposed research will fill a large gap in the health care literature in general and in the ICU literature in particular in which there is a lack of studies that investigate the impact of system-level factors (work obstacles and facilitators) on nursing workload, QWL, and quality and safety of care. [unreadable] [unreadable]